Invasive Aspergillosis in Liver Transplant Recipients in The Current Era
Resource type
Journal Article
Authors/contributors
- Kimura, Muneyoshi (Author)
- Rinaldi, Matteo (Author)
- Kothari, Sagar (Author)
- Giannella, Maddalena (Author)
- Anjan, Shweta (Author)
- Natori, Yoichiro (Author)
- Phoompoung, Pakpoom (Author)
- Gault, Emily (Author)
- Hand, Jonathan (Author)
- D'Asaro, Matilde (Author)
- Neofytos, Dionysios (Author)
- Mueller, Nicolas J. (Author)
- Kremer, Andreas E. (Author)
- Rojko, Tereza (Author)
- Ribnikar, Marija (Author)
- Silveira, Fernanda P. (Author)
- Kohl, Joshua (Author)
- Cano, Angela (Author)
- Torre-Cisneros, Julian (Author)
- San-Juan, Rafael (Author)
- Aguado, Jose Maria (Author)
- Mansoor, Armaghan-E.-Rehman (Author)
- George, Ige Abraham (Author)
- Mularoni, Alessandra (Author)
- Russelli, Giovanna (Author)
- Luong, Me-Linh (Author)
- AlJishi, Yamama A. (Author)
- AlJishi, Maram N. (Author)
- Hamandi, Bassem (Author)
- Selzner, Nazia (Author)
- Husain, Shahid (Author)
Title
Invasive Aspergillosis in Liver Transplant Recipients in The Current Era
Abstract
Invasive aspergillosis (IA) is a rare but fatal disease among liver transplant recipients (LiTRs). We performed a multi-center 1:2 case-control study comparing LiTRs diagnosed with proven/probable IA and controls with no invasive fungal infection. We included 62 IA cases and 124 matched controls. Disseminated infection occurred only in eight cases (13%). 12-week all-cause mortality of IA was 37%. In multivariate analyses, systemic antibiotics usage (adjusted odds ratio [aOR], 4.74; p=0.03) and history of pneumonia (aOR, 48.7; p=0.01) were identified as independent risk factors associated with the occurrence of IA. Moreover, reoperation (aOR, 5.99; p=0.01), systemic antibiotics usage (aOR, 5.03; p=0.04), and anti-mold prophylaxis (aOR, 11.9; p=0.02) were identified as independent risk factors associated with the occurrence of early IA. Among IA cases, Aspergillus colonization (adjusted hazard ration [aHR], 86.9; p<0.001), ICU stay (aHR, 3.67; p=0.02), disseminated IA (aHR, 8.98; p<0.001), and dialysis (aHR, 2.93; p=0.001) were identified as independent risk factors associated with 12-week all-cause mortality; while recent receipt of tacrolimus (aHR, 0.11; p=0.001) was protective. Mortality among LiTRs with IA remains high in the current era. The identified risk factors and protective factors may be useful for establishing robust targeted anti-mold prophylactic and appropriate treatment strategies against IA.
Publication
American Journal of Transplantation: Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Pages
S1600-6135(24)00344-7
Date
2024-05-25
Journal Abbr
Am J Transplant
Language
eng
ISSN
1600-6143
Library Catalog
PubMed
Extra
PMID: 38801991
Citation
Kimura, M., Rinaldi, M., Kothari, S., Giannella, M., Anjan, S., Natori, Y., Phoompoung, P., Gault, E., Hand, J., D’Asaro, M., Neofytos, D., Mueller, N. J., Kremer, A. E., Rojko, T., Ribnikar, M., Silveira, F. P., Kohl, J., Cano, A., Torre-Cisneros, J., … Husain, S. (2024). Invasive Aspergillosis in Liver Transplant Recipients in The Current Era. American Journal of Transplantation: Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, S1600-6135(24)00344-7. https://doi.org/10.1016/j.ajt.2024.05.016
ATC 2024 Top Papers in TID
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